From breast mass to paralysis: lymphocytic mastitis as the sentinel manifestation of Sjögren’s syndrome

Sjögren's syndrome may initially present with rare extra glandular manifestations, preceding classical sicca symptoms and leading to significant diagnostic delay.Lymphocytic mastitis can represent an early autoimmune manifestation of Sjögren's syndrome and may closely mimic infectious or malignant breast disease.Distal renal tubular acidosis is the most frequent renal manifestation of Sjögren's syndrome and may result in life-threatening hypokalemia and acute flaccid paralysis.